MISS MAGDALENE OLUWAMAYOWA BAMBO (NPI# 1790394922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790394922 |
| Entity Type | Individual |
| Full Name | MISS MAGDALENE OLUWAMAYOWA BAMBO |
| Credential | PMHNP |
| Practice Address |
2210 Jackson St Anderson IN 46016-4363 |
| Practice Telephone | 7656468444 |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2020-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
71010375A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
71010275A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2210 JACKSON ST |
| City | ANDERSON |
| State | IN |
| Zip Code | 46016-4363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992705792 | Valerie J Bruderly | Nurse Practitioner | 2210 Jackson St, Anderson, IN 46016-4363 | 2005-07-22 |
| 1295343689 | Glenda Janice Grovenberry | Nurse Practitioner | 2210 Jackson St, Anderson, IN 46016-4363 | 2020-07-21 |
| 1770139586 | Tammy Anne Wolverton | Nurse Practitioner | 2210 Jackson St, Anderson, IN 46016-4363 | 2019-08-16 |
| 1356899934 | Kelly M Ricer | Social Worker | 2210 Jackson St, Anderson, IN 46016-4363 | 2016-09-13 |
| 1417311424 | Anthony Talley | Counselor | 2210 Jackson St, Anderson, IN 46016-4363 | 2016-04-06 |
| 1184087629 | Daniel B Shepler | Nurse Practitioner | 2210 Jackson St, Anderson, IN 46016-4363 | 2016-04-01 |
| 1275938292 | Elizabeth Ploog | Social Worker | 2210 Jackson St, Anderson, IN 46016-4363 | 2014-11-03 |
| 1013340066 | Thomasina Marie Wrangham | Nurse Practitioner | 2210 Jackson St, Anderson, IN 46016-4363 | 2013-08-14 |
| 1023457124 | Lindsay Diemer | Psychiatry & Neurology | 2210 Jackson St, Anderson, IN 46016 | 2013-06-21 |
| 1659624179 | St. Vincent Anderson Regional Hospital, Inc. | Counselor | 2210 Jackson St, Anderson, IN 46016-4363 | 2012-10-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639737356 | Alicia Borer | Optometrist | Macha Family Eye Care, 1537 S. Scatterfield Rd. Suite B, Anderson, IN 46016 | 2019-05-29 |
| 1740681469 | Melissa Dotson | Counselor | 2003 W 12th St, Anderson, IN 46016 | 2014-09-12 |
| 1811164239 | Vicky Lea Lawson | Technician/Technologist | 1503 Rev Jt Menifee Street, Anderson, IN 46016 | 2008-05-14 |
| 1023130812 | Robert L Loudermilk | Dentist | 226 West Historic Eighth Street, Anderson, IN 46016 | 2007-04-04 |
| 1215089297 | Chiropractic Works of Indiana Inc. | Chiropractor | 1541 S Scatterfield Rd, Suite A, Anderson, IN 46016 | 2007-01-18 |
| 1790851509 | Robert W Anderson | Internal Medicine | 2101 Jackson Street, Suite 111, Anderson, IN 46016 | 2006-11-27 |
| 1770668030 | Madison County Community Health Centers Inc | Family Medicine | 1547 Ohio Avenue, Anderson, IN 46016 | 2006-10-26 |
| 1437178035 | Teri L Schulz | Pediatrics | 2020 Meridian St Ste 320, Anderson, IN 46016 | 2006-07-18 |
| 1750331195 | Steven C. Kim | Urology | 141 W. 22nd St., Suite 203, Anderson, IN 46016 | 2006-05-10 |
| 1215905773 | Hazim Rimawi | Internal Medicine | 2020 Meridian St Ste 110, Anderson, IN 46016 | 2006-03-10 |
| Find all providers in zip 46016 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427608603 | Angela Williams | Nurse Practitioner | 5349 Fm 244 Rd, Anderson, TX 77830-8959 | 2019-09-19 |
| 1427443894 | Karen Powell | Nurse Practitioner | 4124 Clemson Blvd Ste E, Anderson, SC 29621-1186 | 2015-04-02 |
| 1992705792 | Valerie J Bruderly | Nurse Practitioner | 2210 Jackson St, Anderson, IN 46016-4363 | 2005-07-22 |
| 1346841947 | Anna Tirman | Nurse Practitioner | 1229 Lincoln St, Anderson, IN 46016-1693 | 2020-11-02 |
| 1295343689 | Glenda Janice Grovenberry | Nurse Practitioner | 2210 Jackson St, Anderson, IN 46016-4363 | 2020-07-21 |
| 1174165054 | Heather Marshall Ford | Nurse Practitioner | 800 N Fant St, Anderson, SC 29621-5708 | 2019-10-12 |
| 1134775463 | Rana Magill Stoops | Nurse Practitioner | 2020 Brown St, Anderson, IN 46016-4218 | 2019-08-13 |
| 1104472406 | Jaima L Byrd | Nurse Practitioner | 2020 Brown St, Anderson, IN 46016-4218 | 2019-08-13 |
| 1306312517 | Deundra T Cooke | Nurse Practitioner | 102 Buford Ave, Anderson, SC 29621-3363 | 2018-10-16 |
| 1013340066 | Thomasina Marie Wrangham | Nurse Practitioner | 2210 Jackson St, Anderson, IN 46016-4363 | 2013-08-14 |
| Find all providers in ANDERSON | ||||
Please comment or provide details below to improve the information on MISS MAGDALENE OLUWAMAYOWA BAMBO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.